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Revue Medicale de Liege Apr 2016Pneumococcal infections remain a major public health issue in aging people. The recent publication of the CAPITA trial evaluating the efficacy of 13-valent pneumococcal... (Review)
Review
Pneumococcal infections remain a major public health issue in aging people. The recent publication of the CAPITA trial evaluating the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13, Prevenar 13®) in elderly subjects has brought several countries including Belgium to modify their vaccinal recommendations. These new developments have motivated us to write this brief review about the burden of pneumococcal disease, the mechanism of action of conjugate vaccines, the clinical efficacy of PCV13 with a special emphasis on CAPITA data. The questions of herd protection and serotype substitution are also introduced as well as a summary of the more recent guidelines.
Topics: Adult; Humans; Pneumococcal Vaccines; Vaccines, Conjugate
PubMed: 27295901
DOI: No ID Found -
Nederlands Tijdschrift Voor Geneeskunde 2015The efficacy of 13-valent polysaccharide conjugate vaccine (PCV13) was studied in a randomised, placebo-controlled trial involving 84,496 adults aged ≥ 65 years of...
The efficacy of 13-valent polysaccharide conjugate vaccine (PCV13) was studied in a randomised, placebo-controlled trial involving 84,496 adults aged ≥ 65 years of age. PCV13 was partly effective in preventing vaccine-type pneumococcal pneumonia, but not in preventing either community-acquired pneumonia from any cause or death. The limited added value for individuals and society calls for reflection rather than mass vaccination. Emphasis on adequate and timely diagnosis of pneumonia with appropriate, personalised management - combined with 'tender loving care', particularly for the frail elderly - is a better option than the ongoing, costly search for the ultimate vaccine to prevent pneumococcal pneumonia.
Topics: Aged; Community-Acquired Infections; Cost-Benefit Analysis; Disease Management; Frail Elderly; Humans; Mass Vaccination; Pneumococcal Vaccines; Pneumonia, Pneumococcal; Vaccines, Conjugate
PubMed: 26271173
DOI: No ID Found -
The Cochrane Database of Systematic... Aug 2014Invasive pneumococcal disease is associated with significant mortality and many countries have introduced routine pneumococcal vaccination into their childhood... (Review)
Review
BACKGROUND
Invasive pneumococcal disease is associated with significant mortality and many countries have introduced routine pneumococcal vaccination into their childhood immunisation programmes. Whilst pneumococcal disease in cystic fibrosis is uncommon, pneumococcal immunisation may offer some protection against pulmonary exacerbations caused by this pathogen. In the USA and UK pneumococcal vaccination is currently recommended for all children and adults with cystic fibrosis.
OBJECTIVES
To assess the efficacy of pneumococcal vaccines in reducing morbidity in people with cystic fibrosis.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Cystic Fibrosis Trials Register, which comprises references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. In addition, the pharmaceutical manufacturers of the polysaccharide and conjugate pneumococcal vaccines were approached.Date of the most recent search: 15 May 2014.
SELECTION CRITERIA
Randomised and quasi-randomised controlled trials comparing pneumococcal vaccination (with either a polysaccharide or conjugate pneumococcal vaccine) with non-vaccination or placebo in children or adults with cystic fibrosis were eligible for inclusion.
DATA COLLECTION AND ANALYSIS
No relevant trials were identified.
MAIN RESULTS
There are no trials included in this review.
AUTHORS' CONCLUSIONS
As no trials were identified we cannot draw conclusions on the efficacy of routine pneumococcal immunisation in people with cystic fibrosis in reducing their morbidity or mortality. As many countries now include pneumococcal immunisation in their routine childhood vaccination schedule it is unlikely that future randomised controlled trials will be initiated. Rigorously conducted epidemiological studies may offer the opportunity to evaluate the efficacy of pneumococcal vaccination in reducing morbidity and mortality in people with cystic fibrosis.
Topics: Adult; Child; Cystic Fibrosis; Humans; Pneumococcal Infections; Pneumococcal Vaccines
PubMed: 25093421
DOI: 10.1002/14651858.CD008865.pub3 -
Turkish Journal of Haematology :... Feb 2021
Review
Topics: Aged; Chromosomes, Human, Pair 8; Dermatitis; Female; Humans; Myelodysplastic Syndromes; Pneumococcal Infections; Pneumococcal Vaccines; Symptom Assessment; Trisomy
PubMed: 33635039
DOI: 10.4274/tjh.galenos.2021.2020.0664 -
JAMA Internal Medicine Sep 2023
Topics: Humans; Infant; Streptococcus pneumoniae; Pneumococcal Vaccines; Necrosis; Pneumococcal Infections
PubMed: 37399033
DOI: 10.1001/jamainternmed.2023.2146 -
Vaccine Oct 2018This narrative review summarizes the current literature relating to pneumococcal vaccination in adult solid organ transplant (SOT) recipients, who are at risk of... (Review)
Review
This narrative review summarizes the current literature relating to pneumococcal vaccination in adult solid organ transplant (SOT) recipients, who are at risk of invasive pneumococcal disease (IPD) with its attendant high morbidity and mortality. The effect of the pneumococcal polysaccharide vaccine has been examined in several small cohort studies in SOT recipients, most of which were kidney transplant recipients. The outcomes for these studies have been laboratory seroresponses or functional antibody titers. Overall, in most of these studies the transplant recipients were capable of generating measurable serological responses to pneumococcal vaccination but these responses were less than those of healthy controls. A mathematical model estimated the effectiveness of polysaccharide vaccination in SOT recipients to be one third less than those of patients with HIV. The evidence for the efficacy of the pneumococcal conjugate vaccine in SOT is based on a small number of randomized controlled trials in liver and kidney transplant recipients. These trials demonstrated that SOT recipients mounted a serological response following vaccination however there was no benefit to the use of prime boosting (conjugate vaccine followed by polysaccharide vaccine). Currently there are no randomized studies investigating the clinical protection rate against IPD after pneumococcal vaccination by either vaccine type or linked to vaccine titers or other responses against pneumococcus. Concerns that vaccination may increase the risk of adverse alloresponses such as rejection and generation of donor specific antibodies are not supported by studies examining this aspect of vaccine safety. Pneumococcal vaccination is a potentially important strategy to reduce IPD in SOT recipients and is associated with excellent safety. Current international recommendations are based on expert opinion from conflicting data, hence there is a clear need for further high-quality studies in this high-risk population examining optimal vaccination regimens. Such studies should focus on strategies to optimize functional immune responses.
Topics: Heptavalent Pneumococcal Conjugate Vaccine; Humans; Pneumococcal Infections; Pneumococcal Vaccines; Transplants; Vaccination; Vaccines, Conjugate
PubMed: 30217523
DOI: 10.1016/j.vaccine.2018.08.069 -
JAMA Feb 2015
Topics: Advisory Committees; Aged; Humans; Immunization, Secondary; Pneumococcal Infections; Pneumococcal Vaccines; Practice Guidelines as Topic; Streptococcus pneumoniae
PubMed: 25688784
DOI: 10.1001/jama.2015.63 -
Expert Review of Vaccines Feb 2017Pneumococcal infection is a public health concern that disproportionately affects the young, the elderly, and the immunocompromised. There is an open debate on the... (Review)
Review
Pneumococcal infection is a public health concern that disproportionately affects the young, the elderly, and the immunocompromised. There is an open debate on the implementation of polysaccharide and/or conjugate vaccines for pneumococcal diseases in adults and the elderly in many countries. The aim of this paper is to systematically review the economic profile of pneumococcal vaccines in adults in terms of costs and benefits. Areas covered: The search for economic studies on pneumococcal vaccination was carried out in Pubmed, Embase, Scopus, and the HTA and NHS EED databases and through a manual search in journals dealing with economic evaluations. We included original articles and reviews with economic evaluation of polysaccharide 23-valent (PPV23) and/or conjugate pneumococcal vaccine 13-valent (PCV13) use in adults, the elderly, and at-risk groups to provide a systematic review of economical evaluation. Expert commentary: Pneumococcal vaccination is strongly recommended for all adults, especially subjects at risk and the elderly. Pneumococcal vaccination with PCV13 or PPV23 in adults is good value for money and should be a priority for the decision-makers. The main issue is how vaccination could be offered.
Topics: Adult; Aged; Aged, 80 and over; Cost-Benefit Analysis; Humans; Middle Aged; Pneumococcal Infections; Pneumococcal Vaccines; Vaccination
PubMed: 27680425
DOI: 10.1080/14760584.2017.1242419 -
European Journal of Clinical... Jan 2015Individuals <2 years and ≥ 50 years of age, as well as those with other specific risk factors, are especially vulnerable to invasive pneumococcal disease (IPD).... (Review)
Review
Individuals <2 years and ≥ 50 years of age, as well as those with other specific risk factors, are especially vulnerable to invasive pneumococcal disease (IPD). Conjugate vaccines have been developed against encapsulated bacteria such as Streptococcus pneumoniae to provide improved immune responses. The 7-valent pneumococcal conjugate vaccine (PCV7) has significantly reduced the burden of vaccine-type pneumococcal diseases in children, including invasive disease and pneumonia and acute otitis media. There have also been significant declines in antimicrobial resistance in 7-valent vaccine serotypes and carriage of S. pneumoniae in the post-PCV7 era. Two to three years after the introduction of PCV13, there is emerging, global evidence of a reduced burden of pneumococcal diseases in children, including declines in IPD (UK and Germany) and nasopharyngeal carriage of PCV13 serotypes (Portugal and France). The functional immunogenicity of PCV13 in individuals ≥ 50 years of age has been demonstrated in clinical trials in comparison with the 23-valent pneumococcal polysaccharide vaccine and for children and adults 6 to 49 years of age. Between 2011 and 2013, PCV13 received market authorisation by the European Medicines Agency (EMA) for these additional age groups and is now available in Europe for the prevention of pneumococcal disease in all age groups.
Topics: Carrier State; Europe; Heptavalent Pneumococcal Conjugate Vaccine; Humans; Nasopharynx; Pneumococcal Infections; Pneumococcal Vaccines; Prevalence; Streptococcus pneumoniae; Vaccination
PubMed: 25149825
DOI: 10.1007/s10096-014-2208-6 -
Human Vaccines & Immunotherapeutics Jul 2016The recent recommendation for the use of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults 65 y of age and older, provides a new tool for preventing disease...
The recent recommendation for the use of the 13-valent pneumococcal conjugate vaccine (PCV13) in adults 65 y of age and older, provides a new tool for preventing disease in this at-risk population. The conjugate vaccine induces a T-cell dependent response, which distinguishes it from the polysaccharide vaccine and could provide the longer-term protection necessary to have a significant impact in this population.
Topics: Adult; Aged; Aged, 80 and over; Humans; Pneumococcal Infections; Pneumococcal Vaccines
PubMed: 26901618
DOI: 10.1080/21645515.2016.1147638